Provider Demographics
NPI:1386858629
Name:LACOURT, ERIN T (LAC)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:T
Last Name:LACOURT
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4218 W WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46619-2622
Mailing Address - Country:US
Mailing Address - Phone:574-233-1524
Mailing Address - Fax:574-233-1612
Practice Address - Street 1:4218 W WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46619-2617
Practice Address - Country:US
Practice Address - Phone:574-233-1524
Practice Address - Fax:574-233-1612
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)